By Kanu Chatterjee
Cardiac medications describes the newest advances within the speedily evolving region of cardiovascular pharmacology. Written by way of popular, USbased specialists in cardiology, this booklet discusses the drug teams for various ailments, equivalent to acute coronary syndromes, high blood pressure, angina and center failure. Separate chapters learn cardiac medications in being pregnant and lactation, and destiny instructions. more desirable by means of complete color pictures and illustrations, this straightforward to keep on with textual content deals functional recommendation on easy methods to deal with cardiac ailments, with a spotlight on hands-on healing information for clinicians.
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Matrix degrading enzymes, matrix metalloproteinases (MMPs), particularly MMP-2 and MMP-9, are increased in thoracic and aortic aneurysms and have been suggested to be contributing factor in the pathogenesis of aortic aneurysms. In animal model, AT1 receptors blockade was associated with decreased expression of MMP-2 and MMP-9, which is another rationale for the use of AT1 receptors blocking agent for treatment of aortic aneurysms. ALDOSTERONE INHIBITORS: SPIRONOLACTONE AND EPLERENONE Introduction Aldosterone, a mineralocorticoid hormone and product of the RAAS, has been linked to hypertension, cardiac remodeling, and vascular fibrosis.
PRO. Cardiol Clin. 2010;28(2):273-7. 64. Cook JR, Nistala H, Ramirez F. Drug-based therapies for vascular disease in Marfan syndrome: from mouse models to human patients. Mt Sinai J Med. 2010;77(4):366-73. 65. Habashi JP, Doyle JJ, Holm TM, Aziz H, Schoenhoff F, Bedja D, et al. Angiotensin II type 2 receptor signaling attenuates aortic aneurysm in mice through ERK antagonism. Science. 2011;332(6027):361-5. 66. Fujiwara Y, Shiraya S Miyake T, Yamakawa S, Aoki M, Makino H, et al. Inhibition of experimental abdominal aortic aneurysm in a rat model by the angiotensin receptor blocker valsartan.
The dose of ARBs is largely based on clinical trials, and one dose does not fit all patients (Table 5). 51 It indicated that losartan at 150 mg/day reduced the rate of death or admission to the hospital for HF more than the commonly used dose of losartan 50 mg/day. This supports the value of uptitrating the ARBs dose to achieve clinical benefit, but it is unlikely that additional large clinical trials comparing dose strength will be performed. Choice of Angiotensin Receptor Blockers Although different ARBs have different affinity for the AT1 receptors and may have different clinical effects, most ARBs studied in patients with systolic HF demonstrated a reduction in mortality and hospitalization.